Provider Demographics
NPI:1285634204
Name:BEESON, THOMAS F (MD PC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:BEESON
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-0220
Mailing Address - Country:US
Mailing Address - Phone:406-233-2543
Mailing Address - Fax:406-233-2567
Practice Address - Street 1:2600 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5094
Practice Address - Country:US
Practice Address - Phone:406-233-2543
Practice Address - Fax:406-233-2567
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6915208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CG8850OtherRAILROAD MEDICARE
MT0014963Medicaid
MT0014963Medicaid